Outline

Objective

Clinical findings in chronically central serous retinopathy (CSR) are variable and difficult to handle. We present a patient 52 years of age with chronical subfoveal and parafoveal leckage in fluorescein angiography (FA) without spontaneous improvement for two years. The OCT (OCT III, Humphrey/Zeiss) displayed a subfoveal detachment of the pigmentepithelium (PED) in combination with an accumulation of subretinal serous fluid.

Methods

Initially the patient had a visual acuity of 0,63. A confluent focal photocoagulation of the leckage area and the pigment epithelium detachment (PED) was performed by Selective-RPE-Laser-Treatment (SRT). Selective-RPE-Laser-Treatment (SRT) uses a frequency doubled Q-switched Nd:YLF Lasers (527 nm). Each laser exposition applies a train of 30 pulses, each of 1,7 μs duration, at a repetition rate of 100 Hz. The spotsize is 120 μm. SRT selectively damages RPR cells while sparing retinal structures.

Results

Post SRT subretinal serous fluid resorbed completely within 10 weeks. In spite of confluent Selective-RPE-Laser-Treatment (SRT) visual acuity remained the same (V=0,63). The pigment epithelium detachment (PED) remained unaffected, in particular there was no RIP-Syndrom observed.

Conclusions

Due to its selectivity it seems possible to treat pathological retina findings by Selective-RPE-Laser-Treatment (SRT) associated with pigmentepithelium detachment (PED) without causing residual damage effectively.